The chronic constipation associated with conditions such as IBS can lead to serious health complications if left untreated.
Constipation is the Rodney Dangerfield of common conditions—it rarely receives the respect it deserves. Just because it’s common and usually treatable with dietary changes or OTC laxatives, many people—patients and clinicians alike—think constipation is simply an annoying inconvenience.
It can, however, have serious health consequences. Straining affects cerebral and coronary circulations, and can cause syncope or transient ischemic attacks when the parasympathetic nervous system causes blood pressure to fall during bowel movements. Epidemiologists report that up to 8% of sudden cardiac deaths occur after patients with an existing circulatory issue strain to eject a stool; these patients may instinctively use the Valsalva maneuver (attempting to forcibly exhale while keeping the mouth and nose closed) to force hard feces from the rectum.
Every individual has a different definition of constipation, which is not a diagnosis but a symptom constellation, because normal elimination patterns vary. Many people have a bowel movement daily, whereas others go more than once a day and some only a few times a week. With little consensus about the best way to manage constipation, treating it presents a challenge.
At any given time, up to one-fourth of Americans are constipated. Patients who are older than 65 years, pregnant, or who have conditions such as IBS are at increased risk. Patients harbor all kinds of myths about constipation, and pharmacists can help dispel those myths. For example, patients often believe that constipation causes the body to absorb poisonous substances from stools or causes disease. It does neither. Colonic irrigation, contrary to popular belief, does not remove toxins and can damage the colonic environment.